Comparative Study

. 2025 Jun;131(8):1651-1660.

doi: 10.1002/jso.28108. Epub 2025 Mar 28.

Robot-Assisted Versus Open Radical Cystectomy: Comparison of Adverse In-Hospital Outcomes

Francesco Di Bello^{1

2}, Natali Rodriguez Peñaranda^{1

3}, Andrea Marmiroli^{1

4

5}, Mattia Longoni^{1

6

7}, Fabian Falkenbach^{1

8}, Quynh Chi Le^{1

9}, Zhe Tian¹, Jordan A Goyal¹, Claudia Collà Ruvolo², Gianluigi Califano², Massimiliano Creta², Fred Saad¹, Shahrokh F Shariat^{10

11

12

13}, Stefano Puliatti³, Ottavio De Cobelli^{4

5}, Alberto Briganti^{6

7}, Markus Graefen⁸, Felix H K Chun⁹, Nicola Longo², Pierre I Karakiewicz¹

Affiliations

¹ Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
² Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.
³ Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S. Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, Italy.
⁴ Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
⁵ Urology Unit, Università degli Studi di Milano, Milan, Italy.
⁶ Urology Unit, Vita-Salute San Raffaele University, Milan, Italy.
⁷ Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁸ Urology Unit, Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
⁹ Department of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
¹⁰ Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
¹¹ Department of Urology, Weill Cornell Medical College, New York, New York, USA.
¹² Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
¹³ Urology Unit, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.

PMID: 40152714
DOI: 10.1002/jso.28108

Comparative Study

Robot-Assisted Versus Open Radical Cystectomy: Comparison of Adverse In-Hospital Outcomes

Francesco Di Bello et al. J Surg Oncol. 2025 Jun.

. 2025 Jun;131(8):1651-1660.

doi: 10.1002/jso.28108. Epub 2025 Mar 28.

Authors

Affiliations

¹ Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
² Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.
³ Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S. Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, Italy.
⁴ Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
⁵ Urology Unit, Università degli Studi di Milano, Milan, Italy.
⁶ Urology Unit, Vita-Salute San Raffaele University, Milan, Italy.
⁷ Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁸ Urology Unit, Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
⁹ Department of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
¹⁰ Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
¹¹ Department of Urology, Weill Cornell Medical College, New York, New York, USA.
¹² Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
¹³ Urology Unit, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.

PMID: 40152714
DOI: 10.1002/jso.28108

Abstract

Purpose: To quantify improvements in adverse in-hospital outcomes between historical and contemporary robot-assisted radical cystectomy (RARC) versus historical and contemporary open RC (ORC).

Material and methods: Within the National Inpatient Sample (2010-2019), RARC and ORC ileal conduit diversion patients were identified. Multivariable logistic and Poisson regression models were fitted.

Results: Of RARC patients, 1343 (39%) were historical (2010-2014) and 2087 (61%) were contemporary (2015-2019). Of ORC patients, 5812 (54%) were historical and 5019 (46%) were contemporary. Versus historical counterparts, contemporary RARC patients exhibited significantly better adverse in-hospital outcomes in 9 of 13 categories, with improvements ranging from -82% for intraoperative complications to -22% for cumulative postoperative complications. Similarly, versus historical, contemporary ORC patients also exhibited significantly better adverse in-hospital outcomes in 9 of 13 categories, with improvements ranging from -72% for intraoperative complications to -12% for median length of stay (LOS). When contemporary RARC was compared to contemporary ORC, RARC adverse in-hospital outcomes were better in 7 of 13 comparisons, with improvements ranging from -55% for blood transfusions to -18% for median LOS. Similarly, when historical RARC was compared to historical ORC, RARC adverse in-hospital outcomes were better in 6 of 13 comparisons, with improvements ranging from -55% for blood transfusions to -15% for median LOS.

Conclusion: The magnitude of the improvement in adverse in-hospital outcomes was comparable between contemporary versus historical RARC (nine improved categories) and contemporary versus historical ORC (nine improved categories). However, contemporary RARC outperformed contemporary ORC in 7 of 13 categories of adverse in-hospital outcomes.

Keywords: NIS; bladder cancer; complications; surgery.

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Robot-Assisted Versus Open Radical Cystectomy: Comparison of Adverse In-Hospital Outcomes

Affiliations

Robot-Assisted Versus Open Radical Cystectomy: Comparison of Adverse In-Hospital Outcomes

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